乳晕同心双环切口乳腺区段切除缩乳术

Reduction mammaplasty of section resection of glandular tissue with periareolar concentric double ring incisions

目的 介绍一种乳房缩小术的新方法。方法 以乳头为中心在乳晕缘及其外周作内、外两同心圆切口 ,两圆半径相距 2～ 4cm ,双环间去表皮 ,在外环切口以外的乳房范围内作广泛的皮下分离 ;在剥离出的乳腺内、外及下方分别对乳腺组织作放射状桔瓣样楔形区段切除 ,保留第 4肋间神经径路的乳腺组织和剩余乳腺结构的完整性 ,分层缝合缺损部乳腺组织 ,利用乳晕外周的真皮帽与其周围的乳腺组织塑形缝合 ,用 7号丝线在乳腺上部向第 2、3肋固定缝合数针。外圆环切口用荷包式缝合 ,将其缩小到与内圆环切口相等 ,然后缝合切口。结果 共为 8例 15只乳房轻、中度巨乳症施行手术 ,乳头、乳晕无坏死且功能良好 ,切口瘢痕不明显 ,形态满意。随访病例中 1例婚育者哺乳功能良好。结论 乳晕同心双环切口乳腺基底蒂乳腺区段切除缩乳术是一种无明显瘢痕、形态好 ,保持乳房功能、设计更合理的术式 ,适应于轻。

Objective To introduce a new technique for reduction mammaplasty. Methods Design the concentric double ring incisions around the nipple, where the difference of the two semidiameters is 2～4 cm. Having removed the epidermis between two incisions, the extensive subcutaneous separation is adopted beyond the outer incision. Then three wedge shaped sections of glandular tissue in medial, lateral and inferior area are excised, retaining the structural integrality of the residual breast tissue and that in the route of IV intercostal nerve. After closure of the glandular tissue, remold the residual breast tissue by stitching the periareola dermal cap with peripheral glandular tissue and by a few sutures anchoring to the II and III ribs. Utilize purse string sutures to reduce the outer incision to the size of the inner one. Results\ The technique has been used in 8 cases (15 breasts) of slight or moderate hypertrophic breast, which provided satisfactory results, maintaining nice configuration and good function with 1 case lactating well, without obvious scar and necrosis of the nipple areola complex. Conclusion\ The technique of reduction mammaplasty with periareola concentric double ring incisions and the pedicle of glandular tissue of nipple areola complex is a very reasonable method to obtain nice breast configuration and good function without obvious scar, fitting to slight or moderate hypertrophic breast.